Article

Two styles of acupuncture for treating painful diabetic neuropathy - A pilot randomised control trial

Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA.
Acupuncture in Medicine (Impact Factor: 1.68). 07/2007; 25(1-2):11-7. DOI: 10.1136/aim.25.1-2.11
Source: PubMed

ABSTRACT In a pilot study, we evaluated the clinical and mechanistic effects of two styles of acupuncture, Traditional Chinese Medicine (TCM) and Japanese acupuncture, for the treatment of painful diabetic neuropathy. Out of seven patients enrolled, three received Traditional Chinese acupuncture while four received Japanese style acupuncture. Treatments were delivered once a week for 10 weeks. Acupuncturists were permitted to select the needle interventions. Substantial differences in diagnostic techniques, choice of acupuncture points, and needle manipulation were observed between TCM and Japanese acupuncturists. Clinically, patients allocated to Japanese acupuncture reported decreased neuropathy-associated pain according to the daily pain severity score, while the group allocated to the TCM acupuncture reported minimal effects. Both acupuncture styles, however, lowered pain according to the McGill Short Form Pain Score. The TCM style improved nerve sensation according to quantitative sensory testing while the Japanese style had a more equivocal effect. No evident changes were observed in glucose control or heart rate variability in either group.

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    • "Few reports have published on its effect. Several studies demonstrated beneficial effects of acupuncture in diabetic neuropathy [11] [12] [13] [14], HIV-associated neuropathy [15] [16], and in peripheral neuropathy with an unclear etiology [17]. The very limited conclusions from these studies resulted either from the small number of treated patients, the uncontrolled study design, or the publications in Chinese journals with merely an abstract in English and therefore not easy to evaluate . "
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    ABSTRACT: Purpose. Chemotherapy-induced peripheral neuropathy (CIPN) is a common and dose-limiting side effect of cytostatic drugs. Since there are no proven therapeutic procedures against CIPN, we were interested to define the role of electroacupuncture (EA) from which preliminary data showed promising results. Methods. In a randomized trial with a group sequential adaptive design in patients with CIPN, we compared EA (LV3, SP9, GB41, GB34, LI4, LI11, SI3, and HT3; n = 14) with hydroelectric baths (HB, n = 14), vitamin B1/B6 capsules (300/300 mg daily; VitB, n = 15), and placebo capsules (n = 17). The statistical power in this trial was primarily calculated for proving EA only, so results of HB and VitB are pilot data. Results. CIPN complaints improved by 0.8 ± 1.2 (EA), 1.7 ± 1.7 (HB), 1.6 ± 2.0 (VitB), and 1.3 ± 1.3 points (placebo) on a 10-point numeric rating scale without significant difference between treatment groups or placebo. In addition no significant differences in sensory nerve conduction studies or quality of life (EORTC QLQ-C30) were found. Conclusions. The used EA concept, HB, and VitB were not superior to placebo. Since, contrary to our results, studies with different acupuncture concepts showed a positive effect on CIPN, the effect of acupuncture on CIPN remains unclear. Further randomized, placebo controlled studies seem necessary. This trial is registered with DRKS00004448.
    Evidence-based Complementary and Alternative Medicine 08/2013; 2013:349653. DOI:10.1155/2013/349653 · 1.88 Impact Factor
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    • "After further reading, however, we excluded 9 references [4]–[12] published in duplicate and 4 references [6], [13], [14], [15] having two or more control groups. Finally, we adopted 75 eligible references, among which 73 references are in Chinese version and the other two in English [16], [17]. All were published between the year 1995 and 2011. "
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    ABSTRACT: To evaluate the reports' qualities which are about randomized controlled trials (RCTs) of acupuncture treatment on Diabetic Peripheral Neuropathy (DPN). Eight databases including The Cochrane Library(1993-Sept.,2011), PubMed (1980-Sept., 2011), EMbase (1980-Sept.,2011), SCI Expanded (1998-Sept.,2011), China Biomedicine Database Disc (CBMdisc, 1978-Sept., 2011), China National Knowledge Infrastructure (CNKI, 1979-Sept., 2011 ), VIP (a full text issues database of China, 1989-Sept., 2011), Wan Fang (another full text issues database of China 1998-Sept., 2011) were searched systematically. Hand search for further references was conducted. Language was limited to Chinese and English. We identified 75 RCTs that used acupuncture as an intervention and assessed the quality of these reports with the Consolidated Standards for Reporting of Trials statement 2010 (CONSORT2010) and Standards for Reporting Interventions Controlled Trials of Acupuncture 2010(STRICTA2010). 24 articles (32%) applied the method of random allocation of sequences. No article gave the description of the mechanism of allocation concealment, no experiment applied the method of blinding. Only one article (1.47%) could be identified directly from its title as about the Randomized Controlled Trials, and only 4 articles gave description of the experimental design. No article mentioned the number of cases lost or eliminated. During one experiment, acupuncture syncope led to temporal interruption of the therapy. Two articles (2.94%) recorded the number of needles, and 8 articles (11.76%) mentioned the depth of needle insertion. None of articles reported the base of calculation of sample size, or has any analysis about the metaphase of an experiment or an explanation of its interruption. One (1.47%) mentioned intentional analysis (ITT). The quality of the reports on RCTs of acupuncture for Diabetic Peripheral Neuropathy is moderate to low. The CONSORT2010 and STRICTA2010 should be used to standardize the reporting of RCTs of acupuncture in future.
    PLoS ONE 07/2012; 7(7):e38461. DOI:10.1371/journal.pone.0038461 · 3.23 Impact Factor
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    • "Zhao (2008) also demonstrated that acupuncture activates both myelinated and unmyelinated nerve fibers. Studies on the use of acupuncture to combat symptoms related to peripheral neuropathy have been conducted in patients with diabetes (Ahn, Bennani, Freeman, Hamdy, & Kaptchuk, 2007; Zhang, Ma, & Yan, 2010; Tong, Guo, & Han, 2010). "
    05/2012; 3(3):178-81. DOI:10.6004/jadpro.2012.3.3.6
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